Nieuw bewijs: hoe rijker, hoe gezonder

No matter how much you earn, people who earn more than you are likelier to be healthier and live longer. That’s the takeaway from a new report by researchers at the Urban Institute and Virginia Commonwealth University examining the complex links between health, wealth, and income.

It shouldn’t surprise anyone that poverty is often associated with poor health. Less obvious: Health and income improve together all the way up the economic pyramid. The wealthiest have fewer illnesses than the upper-middle class, who are in better shape than the lower-middle class, and so on.

The Urban report analyzed a dozen health problems for which the Centers for Disease Control (CDC) has recorded prevalence by family income. In every case, the rich are better off. With just a few exceptions, there’s a steady improvement in health as you climb the income scale:

Life expectancy and self-reported overall health also decline with income. And while minorities in the U.S. have poorer health, much of the difference is accounted for by disparities in income among racial and ethnic groups.

Fewer stroke patients

Here’s another way to think about it: 6.4 million people in the U.S. have suffered strokes, a prevalence rate of 2.7 percent of noninstitutionalized adults. Among those who earn six figures, the rate is 1.6 percent. If everyone had strokes at the same rate that the richest Americans do, we’d have 2.6 million fewer stroke patients in the country. Multiply such differences across a range of health conditions—diabetes, heart disease, lung disease—and the magnitude of health disparities becomes clear.

How health and money are related is complex. For both rich and poor, the two attributes likely reinforce one another. ”Health and income affect each other in both directions: not only does higher income facilitate better health, but poor health and disabilities can make it harder for someone to succeed in school or to secure and retain a high-paying job,” the Urban authors write.

More likely to smoke or be obese

Living in poverty often means less access to nutritious food or neighborhoods safe for outdoor exercise. Low-income people are more likely to smoke or be obese. White-collar jobs are less physically demanding, and people who have them can afford to take a day off for a doctors’ visit or to get a gym membership. They’re also probably not working the night shift, which is linked to cancer and other health problems.

The entanglement between health and income means that stagnant real wages and increasing inequality affect the country’s physical and mental health as well. From the Urban report: “It is important to remember that economic and social policies are health policies in that they affect life expectancy, disease rates, and health care costs for all Americans.”